A case of solitary choroidal tuberculoma in an immunocompetent young male

Abstract

Intraocular tuberculosis is a rare event and occurs in 1 of all diagnosed cases of tuberculosis. It occurs by          haematogenous spread of mycobacterial organism. Choroidal tuberculosis is the most common initial manifestation of         intraocular tuberculosis. A 19 yr old male presented with  complaints of diminished vision in RE for 10 days. Best           corrected visual acuity RE 660 LE 66.BE Anterior segment normal. Fundus examination RE shows a solitary yellowish white choroidal lesion with irregular, fuzzy margins involving the macula, along with a superficial pre-retinal hemorrhage and surrounding retinal edema. Disc was mildly                     hyperemic. FFA confirmed a choroidal lesion with early            hypofluorescence and late moderate hyper fluorescence with surrounding blocked fluorescence due to pre-retinal                hemorrhage. Mantoux test and Quantiferon TB Gold assay were positive. He was started on four drug regimen ATT. After 2 weeks, oral steroids in tapering doses was started. After 4 weeks, the lesion started to resolve with vision improving to 618.